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Mariana Rossi Thorell, Tariq Aslam, Tarik Saddik, Sajjad Mahmood, Romi Chhabra, Konstantinos Balaskas; A Modified Treat and Extend Approach for the Treatment of Retinal Vein Occlusion with Ranibizumab. Invest. Ophthalmol. Vis. Sci. 2017;58(8):1560. doi: https://doi.org/.
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Existing evidence supports the rationale of an individualized approach for the treatment of macular edema (ME) secondary to RVOs with anti-VEGF. However, real-world experience on this treatment approach is limited. We report the results of anti-VEGF treatment with intravitreal injection of ranibizumab using a treat and extend regimen for patients with ME resulting from retinal vein occlusion (RVO).
Retrospective review of patients from a large academic ophthalmology practice with ME due to RVO under intravitreal ranibizumab using a treat and extend approach for at least one year was undertaken. Demographic data, dates of injections, best-corrected visual acuity (BCVA) and central retinal thickness (CRT) on spectral domain OCT of all visits were collected. Change in BCVA and CRT, and retreatment intervals were analyzed.
A total of 28 eyes 27 patients with RVO were identified, of whom 71.43% with branch retinal vein occlusion (BRVO), 7.14% with hemiretinal vein occlusion (HRVO) and 21.43% with central retinal vein occlusion (CRVO). The mean age ± standard deviation (SD) was 72 ± 9.35 years old, and 53.57% of subjects were male. The average BCVA ± SD improvement observed was 13.96 ± 11.24 ETDRS letters. The mean baseline CRT decreased from 486.43 to 213.18 µm. The average retreatment interval ± SD was 6.53 ± 2.51 weeks for the BRVO group, 6.71 ± 2.61 weeks for the CRVO group and 6.39 ± 1.41 for the HRVO group.
The treat and extend approach in RVO patients with ME treated for at least one year with intravitreal ranibizumab improved BCVA and decreased CRT. This protocol showed effectiveness in increasing the interval of retreatment and consequently reducing the burden of care for patients and the service. The data may help clinicians’ decision and patients’ expectation.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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